Maya Nicole Georgallis, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT.0004114 Issued in CO

Practice address

3609 S Timberline Rd
Fort Collins, CO 80525-3430

Phone

(970) 377-0005

NPI assigned

Jun 4, 2025

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Ohio State University - College of Optometry, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Rocky Mountain Family Vision, PC 4 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Rocky Mountain Family Vision, PC

  • Optometrist
  • Fort Collins, CO
  • NPI 1396977906

  CO, Optometrist

  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1748995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748995200000",
    "number": "1053205138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "975 LANDMARK WAY UNIT 7",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805244190",
            "telephone_number": "925-998-5751",
            "fax_number": "925-998-5751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3609 S TIMBERLINE RD",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805253430",
            "telephone_number": "970-377-0005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEORGALLIS",
        "first_name": "MAYA",
        "middle_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-04",
        "last_updated": "2025-06-04",
        "certification_date": "2025-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "OPT.0004114",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Genesis Eldercare Rehabilitation Services LLC
• Stefan C Genet, DO
• Genoa Healthcare LLC
• Deborah Gentry, LCSW
• Sofia Gentry, MSW, LCSW
• Brenda Marie George, D.O.
• Joseph C George, MD
• Melissa RW George, PHD
• Rose George, MD
• Susan Christine George, RN

• All providers in Fort Collins, CO
• Optometrist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.